What Are the Causes of Elevated Blood Sedimentation Rate?
The blood sedimentation rate (ESR) refers to the rate at which red blood cells settle in a test tube within an hour. This test is primarily conducted to identify inflammation in the body as an elevated sedimentation rate often indicates underlying health issues associated with inflammation. Inflammation tends to generate proteins that increase the blood sedimentation rate. Normal ESR values vary as follows:
- Men:
- Under 50 years: 0 – 15 mm/hour.
- Over 50 years: 0 – 20 mm/hour.
- Women:
- Under 50 years: 0 – 20 mm/hour.
- Over 50 years: 0 – 30 mm/hour.
It is important to consider certain factors that may influence the results of the ESR test, including:
- Anemia.
- Age.
- Kidney issues.
- Thyroid disorders.
- Pregnancy.
- Menstrual cycle.
- Obesity.
- Medications such as:
- Oral contraceptives.
- Vitamin A.
- Corticosteroids.
- Methyldopa.
- Theophylline.
- Quinine.
Causes of Mild Elevation in Blood Sedimentation Rate
A slight increase in the ESR may not necessarily indicate a serious health condition, but it can often be attributed to the following factors:
- Systemic infections.
- Rheumatoid arthritis.
- Bone infections.
- Red blood cell disorders.
- Tuberculosis.
- Various forms of leukemia.
- Heart infections.
Causes of Significant Elevation in Blood Sedimentation Rate
Significant increases in ESR can be due to various conditions, including:
Infections
This category includes:
- Bone infections.
- Heart-related infections leading to:
- Myocarditis.
- Pericarditis.
- Endocarditis.
- Rheumatic fever.
- Tuberculosis.
- Infectious skin diseases.
- Systemic infections.
Autoimmune Diseases
Conditions under this category may include:
- Lupus.
- Rheumatoid arthritis.
- Giant cell arteritis.
- Vasculitis.
- Hyperfibrinogenemia.
- Waldensström macroglobulinemia, a rare form of cancer.
Need for Further Testing After Elevated Blood Sedimentation Rate
If the ESR test indicates elevated results, it suggests the presence of inflammation; however, further diagnostic tests are required to identify the underlying cause. These tests may include:
- C-reactive protein (CRP) test, which also measures inflammation markers. Elevated levels are indicative of inflammatory conditions, including those related to cardiovascular health and other disorders.
- Complete blood count (CBC).
- Comprehensive metabolic panel (CMP).
- Antinuclear antibody (ANA) test.
- Rheumatoid factor (RA) test.
- Fibrinogen test.
- Serum protein electrophoresis.
- Other diagnostics based on the patient’s medical history and physical examination may include:
- Imaging studies.
- Biopsy procedures.
When Might a Doctor Recommend a Blood Sedimentation Rate Test?
Several symptoms may prompt a physician to order an ESR test due to their association with inflammatory diseases, such as:
- Arthritis.
- Inflammatory bowel disease (IBD).
These symptoms may encompass:
- Joint pain or stiffness lasting over 30 minutes after waking up.
- Headaches accompanied by symptoms like pain on the sides of the head and vision changes.
- Pain in the shoulders, neck, or pelvis.
- Unexplained weight loss.
- Gastrointestinal symptoms such as:
- Diarrhea.
- Fever.
- Blood in stool.
- Abdominal pain.
Treatment for Elevated Blood Sedimentation Rate
Treatment depends on the underlying cause of the elevated ESR and may include:
- Antibiotics for infection-related cases.
- Corticosteroid medications, such as:
- Methylprednisolone.
- Dexamethasone.
- Nonsteroidal anti-inflammatory drugs (NSAIDs), including:
- Naproxen.
- Diclofenac.
- Celecoxib.
Conclusion
The blood sedimentation rate (ESR) is a measure of how quickly red blood cells settle in a test tube in one hour, primarily used to detect inflammation in the body. An elevated ESR level can be a critical sign of various health issues, often linked with inflammatory processes. Elevated rates are typically associated with the presence of inflammation, attributed to the production of proteins that can increase sedimentation rates.